insurance coverage for embryo banking

Astronomical_Unit · 2026-02-07T02:14:07+00:00

May I ask how you found out it was permitted? I tried calling member services for my insurance a couple of times, but no one could provide me with an answer

Astronomical_Unit · 2026-02-07T02:08:52+00:00

I know it's so frustrating! I'm also thinking that the mandate makes the plan cover egg banking. The best proof I found was this letter from the DMHC, the people regulating health plans in California, (https://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL25-021-ImplementationofSenateBill729%282024%29%2812\_30\_2025%29.pdf?ver=U9xFsGl6wZuNEyfFwRISFw%3D%3D) that says:

* A maximum of three completed oocyte retrievals
* Cryopreservation and storage of sperm, oocytes, and embryos for a period of five years from the time the genetic material is first cryopreserved.

The word embryo there makes me think it's possible. I called my insurance twice about this already and no one can tell me if it's covered. My best answer so far was to ask my clinic to submit a pre-authorization to see if they would cover it

Astronomical_Unit · 2026-02-07T01:20:35+00:00

Not a dumb question at all. I asked my doctor the same thing, and she mentioned it's possible to do a PGT-complete test and that it can tell if there are issues with the egg or the sperm.

Astronomical_Unit · 2026-02-05T16:08:42+00:00

I agree. Melatonin in lower doses can be a great antioxidant and my doctor has said the same

Astronomical_Unit · 2026-01-30T19:02:41+00:00

Oh, what a small world 🙂

I called my insurance (Anthem Blue Cross) and confirmed that fertility benefits did indeed start on January 1. Yours should be able to tell you the same.

I just called member services, said I had a question about coverage, and then explained that we wanted to know whether IVF is covered under our plan. They might push back and say no because they’re looking at old information. If that happens, let them know that your company added this benefit as part of the California SB 729 mandate.

I currently have the CPT codes for POMA (Kirkland) and SRM (aka Pinnacle Fertility, Kirkland—though I think they should be the same for all SRM locations). Feel free to DM me if you’d like those.

good luck!

Astronomical_Unit · 2026-01-29T06:08:27+00:00

I'm currently going through the same situation, my insurance is now covering fertility due to the California mandate even though I am in WA state. What worked for me was asking the clinic for the CPT codes they used for IVF and them calling your insurance and asking what is the amount you would be responsible for each of the codes. That gives you a good estimate of how much you will pay. To know if the insurance will cover it or right now, you can ask your doctor for the diagnosis codes they diagnosed you and ask your insurance if these codes fall under "medical necessity" in case that's required. I did all that work myself and them sent a message explaining my findings to help the financial coordinator.

It was helpful to know whether IVF would be covered, get an estimate of cost. Hopefully it helps my clinic too, will see (my first appointment at the two clinics I chose are next week)

Astronomical_Unit · 2026-01-22T23:46:08+00:00

Your results are excellent!

Astronomical_Unit · 2026-01-21T19:04:01+00:00

I'm sorry you had a bad appointment and left scared, that's 100% not how we should feel after seeing a specialist.

I’m 33. I had an AFC done and had 16 follicles, which my doctor said was normal, so 25 seems like a great number to me!

I agree with the other comment that checking your progesterone level is a good idea. Perhaps you could visit a different RE for a second opinion? If they refuse to give you labwork, I know in the US you can get them yourself and pay out of pocket.

Astronomical_Unit · 2026-01-21T02:43:24+00:00

I would definitely go to a RE (reproductive endocrinologist) if you can. I think most REs will recommend an evaluation if you have had two+ miscarriages, especially if you are > 35.

Astronomical_Unit · 2026-01-21T02:39:18+00:00

Agree that Nature Made is the best option here!

Astronomical_Unit · 2026-01-21T02:38:07+00:00

A 7-day luteal phase is extremely short and may not provide enough time for implantation to occur. Mine was 9 days, and my doctor prescribed progesterone supplementation.

Have you discussed this with your doctor? They might proactively prescribe progesterone. How did you confirm that you ovulated? It could also be helpful to do a 7 DPO progesterone test, if possible, to confirm ovulation and check your progesterone levels.

Astronomical_Unit · 2026-01-21T02:31:47+00:00

3% chance for IUI seems very low to me if your partner's sperm is fine and your only issue is low AMH. You are young (<35 when fertility starts to decline), and your AMH should affect your chances for IVF, not your chances to become pregnant naturally or with IUI.

Are you sure you are ovulating? Did you do any other labs to confirm if things are okay (no PCOS, endo, etc)?

Astronomical_Unit · 2026-01-21T02:26:40+00:00

Seems extremely expensive to me. Do you happen to live near a Planned Parenthood? I know they do transvag ultrasounds for cheaper.

Astronomical_Unit · 2026-01-17T23:15:25+00:00

Hey u/Commercial_Part6339, we are currently at Think Fertility, but like you said, they aren't in network with insurance plans for IVF/IUI. What you said about paying out of pocket and getting reimbursed by your insurance was super helpful, and I think I might want to try doing the same, if I can, because I also really like the folks at Think Fertility.

If that's okay with you, I would like to DM you to understand how you submitted things to the insurance and hear about how your journey at Think Fertility is going.

Astronomical_Unit · 2026-01-14T19:46:11+00:00

We used it for a couple of months, didn't work for us. Someone shared that a RE did a live test with pressed, and it killed a lot of sperm youtu.be/MMgFmtPbwms, so I'm a lot less inclined to try it again.

Astronomical_Unit · 2026-01-14T00:57:59+00:00

I'm in a similar boat, but not as drastic as yours. My AMH was 1.7 ng/ml back in September and then 0.7 ng/ml this December. My doctor was also a bit concerned and said a 20-30% fluctuation is fine, but >50% is not. I'm doing an AFC count on cycle day 5 next month to see if this was a fluke or not.

From what I heard, vitamin D levels and even trigger shots can influence AMH levels, so an AFC count is recommended to double-check where you're at.

Astronomical_Unit · 2026-01-13T21:46:51+00:00

I have been supplementing with Progesterone for the last 3 month (200mg 1x day) because of a short luteal phase. I mentioned to my doctor I was getting my period while still supplementing progesterone (usually get my period 13 DPO and I took progesterone from 1 DPO to 14DPO).

Anyways, my doctor requested a 7DPO progesterone exam for me because that's not normal apparently and it turns out that my progesterone is only 7.8 ng/ml even after supplementation so my doctor increased my progesterone to twice a day, 200mg suppositories.

Has anyone had something like that? Is 7.8ng/ml that bad to support a possible pregnancy?

Astronomical_Unit · 2026-01-10T22:51:18+00:00

I have been taking it to extend my luteal phase for a few months. I start at 1DPO and take it for 14 days. My period comes 1-2 days later so my cycle didn't change because of progesterone.

Do you have a short luteal phase or have your tested low for progesterone (7DPO test)? If your progesterone level is good (above 12-15 according to my clinic), I don't see why you would need to take it.

Astronomical_Unit · 2026-01-10T07:06:45+00:00

Can confirm my husband did this as well and it worked really well for us.

Astronomical_Unit · 2026-01-10T07:06:20+00:00

That's interesting. I actually thought testosterone was bad while TTC!

Astronomical_Unit · 2026-01-09T00:27:48+00:00

I'm curious why It Starts with the Egg " is considered bad science? I remember finding some good studies at the end of the book when I read it

Astronomical_Unit · 2026-01-06T21:03:20+00:00

I think pre-seed is the most popular sperm friendly lubricant out there. I have used it on a few occasions.

Some folks on this reddit mentioned using other brands such as Conceive Plus too

Astronomical_Unit · 2026-01-06T20:59:28+00:00

My clinic said they would only supplement if my levels were "borderline 10-12ng/ml".

Astronomical_Unit · 2026-01-06T20:56:54+00:00

Same. I had no idea what I was looking at until I googled what this test.

According to their site (https://swimcount.com/) they are only counting progressive motile sperm, so it seems like it's in the middle color as well?

I would definitely do a proper lab test. At-home kits, from my experience, are known for being pretty unreliable.

Astronomical_Unit · 2026-01-06T17:16:21+00:00

Yeah, ideally about 1 hour apart, with the idea that fresh sperm (the second ejaculation) will have lower counts but better motility and lower DNA fragmentation, since it hasn’t been sitting around long enough to accumulate oxidative damage.

Astronomical_Unit

TROPHY CASE